Gomez, Tara A

Gomez, Tara A is an individual health care provider with primary practice located at 2300 E 30Th St Bldg D Ste 101 , Farmington NM 87401-8990. She recently has only one registered license in Nursing Service Providers / Orthopedic, which is considered as her primary health care specialty. Gomez, Tara A can be contacted via phone (505) 327-1400.

Contact Information

Primary practice address
2300 E 30Th St Bldg D Ste 101 Farmington NM 87401-8990
Phone: (505) 327-1400
Fax: (505) 564-3202
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Orthopedic 163WX0800X R52863 New Mexico

Profile Details

NPI number 1245423110
LBN Legal business name Gomez, Tara A
Credentials RN SFA
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2007
Last updated May 6th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245423110 NPPES
New Mexico MEDICAID 47522
New Mexico Other 00NM006H18
New Mexico Other 10034667
New Mexico Other R52863

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